Introduction

Sleep apnea is among the most common – and most disturbing – sleep conditions. Millions of Americans suffer nightly from sleep apnea, but new developments and treatments mean they may not have to. Calvin Stafford, M.D., medical director of the Crozer Sleep Disorders Center at Taylor Hospital, recently spoke to a group of local residents interested in learning more about the condition.

For millions of Americans, sleep is a natural, normal event – they drift off at night and awaken in the morning, ready to start their day. For millions more, however, sleep is a constantly interrupted source of frustration. They awake gasping for breath or snore so loudly that family members complain.

This condition, known as sleep apnea, occurs when the structures in the throat relax during sleep, causing the airway to become blocked. Calvin Stafford, M.D., medical director of the Crozer Sleep Disorders Center at Taylor Hospital, discussed the condition, its symptoms and its treatments during a recent lecture at the hospital.

“When the airway is blocked, the body’s ‘fail safe mechanism’ goes to work,” Dr. Stafford says. “What happens next is a partial arousal. The individual with sleep apnea goes into a lighter stage of sleep, the airway opens up, the person takes a few gasping breaths and returns oxygen and carbon dioxide levels to where they belong – but at the expense of quality sleep. If this happens six to eight times in the night, it’s probably no big deal. As it starts to roll forward and happens 50 to 60 times, sleep quality suffers. And when it progresses to severe obstructive sleep apnea – occurring several hundred times over the course of the night – the individual never gets any rest or sleep.”

Dr. Stafford notes that sleep apnea affects individuals in all age groups, from children and teenagers to the elderly. However, males are more predisposed to the condition – about four males will report the condition for every female – and people who are overweight are more prone to sleep apnea.

So how can you tell if you have sleep apnea?

“There are two bright red flags when it comes to sleep apnea,” Dr. Stafford says. “The first is excessive daytime sleepiness. Sleep apnea disrupts your sleep, so people with sleep apnea are tired and sleepy. They may be sleeping during the day or dozing off while they are driving or in other dangerous situations.

“The second flag is called ‘Stentorian’ snoring – really loud snoring. Spouses can usually tell if their partners have sleep apnea, just from the sound of it. That is due to the structures within the throat and airway, which block the airway and produce sleep apnea.”

Other symptoms of sleep apnea may include a morning headache (because of elevated levels of carbon dioxide building up in the body during the night), dry mouth, sore throat and high blood pressure.
In order to reverse mild to moderate sleep apnea, physicians suggest trying some lifestyle changes.
“People with mild to moderate sleep apnea who drink before bed will develop severe sleep apnea,” Dr. Stafford says. “Weight loss is a key treatment over the long haul, but it is very hard to do, so body positioning can help – sleep on your side instead of your back.”

For people with severe sleep apnea, additional techniques may be necessary.

“In cases of severe sleep apnea, we have to do something a little more aggressive to open the airway,” Dr. Stafford says. “A C-PAP is a mask hooked up to an air pump. The pump forces low-pressure air to the individual’s nose and airway, creating a flow to hold the airway open. It’s not breathing for the individual, and it’s not a ventilator – it just acts as a kind of air splint and allows the individual to breathe freely.”

Surgery may also be an option for people with severe sleep apnea.

“In order to open the airway, we can perform a tracheostomy,” Dr. Stafford says. “The surgeon puts a little hole in the airway and inserts a tube with a little plug or cork in it. During the day, the individual can put the cork in the tube and can breathe and talk normally. At night, he removes the plug, thereby bypassing the airway obstruction and sleeping without apnea. However, this technique is not used much anymore, due to the development of the C-PAP and the pure inconvenience of having a hole in your throat.”

Other surgical techniques include tonsillectomy and adenoidectomy (mostly reserved for children), nasal surgery and jaw reconfiguration surgery.